To Evaluate the Role of Postoperative Radiotherapy in Patients With IIIA(N2) Non-Small Cell Lung Cancer
Status:
Recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
Rationale: Completely resected non-small cell lung cancer (NSCLC) patients with
histologically confirmed N2 disease are a heterogeneous population, with 5-year survival
rates ranging from 10% to 30%. Systemic recurrence following surgery is one of the major
problems in stage IIIA(N2) patients, and the use of postoperative chemotherapy (POCT) in
stage IIIA disease prolongs survival. The value of postoperative radiotherapy (PORT) for
completely resected NSCLC remains controversial, as the effect on survival has been
inconclusive. Recently, several large retrospective studies and reviews of the National
Cancer Database indicated that modern PORT appears to confer an additional 5% survival
advantage beyond that achieved with adjuvant chemotherapy alone. Actually, after complete
resection and POCT, 20%-40% of cases have a risk of locoregional recurrence (LRR). Patients
with completely resected stage IIIA(N2) disease might hold different postoperative
patterns-of-failure and prognosis. It is not yet known for subsets with specific prognostic
factors that confer lower LRR risks, whether giving PORT is more effective than no radiation
therapy in treating patients with completely resected pathologic stage IIIA(N2) NSCLC.
Purpose: This randomized phase II trial is studying the clinical efficacy of PORT
administered using three-dimensional conformal radiotherapy (3D-CRT) techniques and the
proposed standard PORT clinical target volume (CTV) delineation guideline in treating low
risk of LRR patients with completely resected pathologic stage IIIA(N2) NSCLC.